<!DOCTYPE html>
<html lang="en"  xmlns:th="http://www.thymeleaf.org">
<head>
    <meta charset="UTF-8">
    <title>用户详情</title>
    <link rel="stylesheet" href="../../../../component/pear/css/pear.css" />
</head>
<body>
<form class="layui-form" action="">
    <div class="mainBox">
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">档案编号</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="docNum"  value="" lay-verify="title" autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>

        </div>

        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">姓名</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="patientName" value=""   lay-verify="required" placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">年龄</label>
                <div class="layui-input-block">
                    <input readonly type="number" name="patientAge"  value="" autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">照片上传</label>
                <div class="layui-input-block">
                    <input  readonly type="text" name="patientPic" value=""  autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
        </div>

        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">性别</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="patientSex"   autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">联系电话</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="patientTel"   autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>

        </div>
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">证件类型</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="cardType"  value=""  placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">证件号</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="cardNum" value=""  autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">出生日期</label>
                <div class="layui-input-block">
                    <input  readonly type="date" name="birth" value=""  lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">现住地址</label>
                <div class="layui-input-block">
                    <input  readonly type="text" name="address"   value=""  placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">民族</label>
                <div class="layui-input-block">
                    <input  readonly type="text" name="ethnic"  value=""   placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">籍贯</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="origin"  value="" autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">婚姻状况</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="wedStatus" value=""  autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">户口地址</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="accountAddress" value=""    placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">社保类型</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="socialSecuritytype" value=""   autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">社保卡号</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="socialSecuritynum" value=""  autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">经济来源</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="financialFrom"  value=""  placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">付费方式</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="payWay" value=""  autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">紧急联系人</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="emergencyContacts"  value=""   placeholder="请输入" autocomplete="off" class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">紧急电话</label>
                <div class="layui-input-block">
                    <input readonly type="text" name="emergencyTel" value=""  autocomplete="off" placeholder="请输入" class="layui-input">
                </div>
            </div>

        </div>

    </div>

</form>
<script src="../../../../component/layui/layui.js"></script>
<script src="../../../../component/pear/pear.js"></script>
<script type="text/html" id="patientSexJudge">

    if(  $("#patientSex").val() == 0){
    $("#patientSex").val("男");
    }else if($("#patientSex").val() == 1){
    $("#patientSex").val("女");
    }


</script>
<script>
layui.use(['form','jquery'],function(){
let form = layui.form;
let $ = layui.jquery;
})
</script>
</body>
</html>